For the past year, Bill and Melinda Gates have received the same question repeatedly while jetting around the world: How is President Donald Trump affecting their work as two of the world's top philanthropists?

The president has rattled it in several ways, they answer. His policies have shaken up the field of family planning, they say, and his derogatory comments about African countries and Haiti have caused disbelief among people they work with outside the United States.

Bill and Melinda Gates.

Photo: AP

"Those disparaging comments don't belong in any public discourse," Melinda Gates said in a recent joint interview with her husband, the co-founder of Microsoft and one of the richest people in the world.

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"That's not how we teach our kids to speak," she continued. "So it's discouraging to hear that kind of talk."

Bill and Melinda Gates are badgered about Trump so often that they made the topic part of the annual letter they published early Tuesday, a digest the couple releases about the philanthropic activities of the Bill and Melinda Gates Foundation. Believed to be the largest in the world, the foundation gave away more than $US41 billion ($52 billion) from its inception in 2000 through the end of 2016, now spending $US4 billion to $US5 billion a year to combat malaria, reduce poverty and improve education.

This is the 10th annual letter the Gateses have published, which they're marking by answering 10 "tough questions" they frequently get. In addition to Trump, they address topics like why they team up with corporations and whether they're imposing their values on other cultures.

Still optimistic

The first Gates letter was inspired by the annual update the billionaire investor Warren E. Buffett writes to shareholders of his holding company, Berkshire Hathaway. In 2006, Buffett, a longtime friend of the couple's, pledged the majority of his fortune to the Gates Foundation, where he is a trustee. In philanthropic circles, the annual Gates letter is read as avidly for tidbits about giving trends as Buffett's letter is by investors.

Warren Buffett is a longtime friend of Bill and Melinda Gates,

Photo: Bloomberg

"There have been some interesting tip-offs about where they're heading or their perspectives on things," said David Callahan, the founder and editor of Inside Philanthropy, a news site about charitable giving.

While the mood in many parts of the world seems to have darkened, Bill and Melinda Gates say in their letter that they remain militantly optimistic about global progress.

"The headlines are filled with awful news," they write in the letter. "Every day brings a different story of political division, violence or natural disaster. Despite the headlines, we see a world that's getting better."

They expanded on some of those themes and fielded questions about other topics in the recent interview. It was held at bgC3, a company that oversees many of Bill Gates' independent projects, including for-profit investments in clean energy.

Through her own private company, Pivotal Ventures, Melinda Gates has advocated for greater participation by women in STEM fields and other gender equity issues. Pivotal recently helped fund Aspect Ventures, the largest venture capital firm led by women. Not long ago, she moved Pivotal to its own private office near her husband's.

As one of the founders of the modern tech industry, Bill Gates is often looked to for technical answers. For instance, while running for president, Trump floated the idea of asking Gates to help close "that internet up in some way" to curb communications by terrorists online.

"The whole tech world should look at these criticisms, look at these effects, you know, try to make sure that without giving up what's good about that, that we can reduce some of it," he said.

When asked if the national reckoning over sexual harassment had affected her investments through Pivotal, Melinda Gates said that it hadn't so far, but that it had encouraged her to use her voice to encourage more women to speak out.

"I want to make it OK for women to talk about their real experience," she said. "I think it's a long time coming that the sexual harassment stuff worldwide comes out."

The Trump view

Melinda Gates has made family planning a focus of her work with the foundation. She said the Trump administration's decision last year to expand a ban prohibiting US aid to any health organisations that provide or discuss abortion in family planning had caused "chaos" in the field — forcing them to stall their work as they figured out how to adhere to the rules.

Bill and Melinda Gates have some reservations about the President.

Photo: AP

And in their annual letter, Melinda Gates, 53, is blunt in her view of the way Trump communicates.

"I wish our president would treat people, and especially women, with more respect when he speaks and tweets," she writes.

A White House spokesman did not respond to requests for comment.

Bill Gates, 62, said he was particularly worried about Trump's threats to cut foreign aid, which the Gates Foundation considers critical in the global battle against disease and poverty. He said that he was reassured that Congress had so far resisted the president's demands to cut aid and that he and his wife had increased their visits to Republican members of Congress to stress the importance of maintaining the aid budget.

"Although we disagree with this administration more than the others we've met with, we believe it's still important to work together whenever possible," he writes in the letter. "We keep talking to them because if the US cuts back on its investments abroad, people in other countries will die, and Americans will be worse off."

One of the questions in the letter is about what happens when the two of them disagree. Bill Gates wrote, "When I get really enthusiastic about something, I count on her to make sure I'm being realistic."

Melinda Gates said they tended to avoid hashing out their disagreements in front of bigger groups at the foundation, saving them for private discussions, which they have on walks.

"Having a little bit of grist in the system is actually a good thing," she said.